氯胺酮联合丙泊酚麻醉的改良电休克治疗对超重抑郁症患者脂肪因子及临床结局的影响  

Effects of ketamine combined with propofol on serum adipokine and clinical outcomes in overweight depression patients with modified electroconvulsive convulsive therapy

作　　者：陈前修 万运强 刘行 CHEN Qianxiu;WAN Yunqiang;LIU Xing(Affiliated Hospital of Southwest Medical University,Luzhou 646000,China)

机构地区：[1]西南医科大学附属医院,四川泸州646000

出　　处：《实用医学杂志》2020年第4期518-521,共4页The Journal of Practical Medicine

基　　金：泸州市科技项目应用基础研究项目(编号:2019LZXNYDJ36)。

摘　　要：目的探讨氯胺酮联合丙泊酚麻醉对超重抑郁症患者行改良电休克治疗(MECT)血清中脂肪因子及临床结局的影响。方法将60例超重抑郁症患者,按照入院先后顺序随机分为两组,即联合组(氯胺酮0.5 mg/kg+丙泊酚0.5 mg/kg,30例)和(丙泊酚1.0 mg/kg),每组30例,采用汉密尔顿抑郁量表(HAMD-17)评估两组MECT治疗前后的抑郁评分,并采集静脉血观察两组治疗前后脂肪因子浓度变化。结果联合组较对照组抑郁评分改善更快(P<0.05),但经过6次MECT治疗后联合组临床疗效未显著好于对照组;联合组脂联素在第4、6次MECT治疗后显著高于对照组(P<0.05),而抵抗素在第4、6次MECT后显著低于对照组(P<0.05),而瘦素在两组之间差异无统计学意义(P>0.05)。结论亚麻醉剂量氯胺酮联合丙泊酚麻醉用于MECT超重抑郁症患者,抑郁评分改善更快,可改善患者体内脂肪因子水平,但未进一步提高临床疗效。Objective To investigate the effects of ketamine combined with propofol on serum adipokine and clinical outcomes in overweight depression patients with modified electroconvulsive convulsive therapy(MECT).Methods Sixtycases of overweight depression patients,thirty cases(experimental group)were treated with ketamine combined with propofol and thirty cases(control group)treated with propofol.The HAMD-17 scale was evaluated before and after MECT,and the differences of adipokine and clinical outcomes between the two groups were compared.Results Ketamine combined with propofol anesthesia improved depression scores faster than propofol alone(P<0.05),but the clinical efficacy of the experiment group was not significantly better than control group after the sixth MECT.Adiponectin in the experiment group was significantly higher than control group after the fourth and sixth MECT(P<0.05),resistin in the experiment group was significantly lower than control group after the fourth and sixth MECT(P<0.05),while leptin was no statistically significant difference between the two groups(P>0.05).Conclusion Ketamine combined with propofol improved depression scores more faster in overweight depression patients with MECT and improved the level of adipokine,but the clinical efficacy not improved further more.

关 键 词：氯胺酮 改良电休克 抑郁症 脂肪因子 

分 类 号：R971.43[医药卫生—药品]